Global increases in antibiotic consumption: a concerning trend for WHO targets

Worldwide, antimicrobial resistance is increasing at an alarming rate. In 2019, WHO listed antimicrobial resistance as one of the top ten threats to global health. 1 WHOTen threats to global health in 2019. https://www.who.int/news-room/feature-stories/ten-threats-to-global-health-in-2019Date: 2019 Date accessed: April 17, 2020 Google Scholar A major driver of antimicrobial resistance is antibiotic overuse and misuse. Efforts to reduce inappropriate prescribing of antibiotics have led to strong general commitments; however, substantial variability in prescribing is present across health systems. Eili Klein and colleagues 2 Klein EY Milkowska-Shibata M Tseng KK et al. Assessment of WHO antibiotic consumption and access targets in 76 countries, 2000–15: an analysis of pharmaceutical sales data. Lancet Infect Dis. 2020; (published online July 24.)https://doi.org/10.1016/S1473-3099(20)30332-7 Summary Full Text Full Text PDF PubMed Scopus (21) Google Scholar did a systematic evaluation of antibiotic consumption according to the WHO AWaRe Classification Database across 76 countries from 2000 to 2015. 3 WHOWHO Model List of Essential Medicines: WHO AWaRe Classification Database of Antibiotics. https://www.who.int/medicines/publications/essentialmedicines/enDate: 2019 Date accessed: April 17, 2020 Google Scholar This study provides valuable insight into antibiotic prescribing trends at a global level. Antibiotics were classified as Access (first-line or second-line therapies), Watch (for use only with specific indications due to higher resistance potentials), or Reserve (for use as a last resort). Over this 15-year study period, overall use per capita increased by 26·2% in Access antibiotics and 90·9% in Watch antibiotics. Relative consumption of Access antibiotics to Watch antibiotics, as measured by the access-to-watch index, decreased substantially on a global level, although this decrease was most pronounced in low-income and middle-income countries. Assessment of WHO antibiotic consumption and access targets in 76 countries, 2000–15: an analysis of pharmaceutical sales dataRapid increases in Watch antibiotic consumption, particularly in LMICs, reflect challenges in antibiotic stewardship. Without policy changes, the WHO national-level target of at least 60% of total antibiotic consumption being in the Access category by 2023, will be difficult to achieve. The AWaRe framework is an important measure of the effort to combat antimicrobial resistance and to ensure equal access to effective antibiotics between countries. Full-Text PDF